Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 115-146.

This article explores how the law of England and Wales1 has responded thus far to medical and clinical advances that have enabled patients with prolonged disorders of consciousness to survive. The authors argue that, although the courts have taken account of much of the science, they are now lagging behind, with the result that some patients are being denied their legal rights under the Mental Capacity Act 2005. The article further argues that English law does not comply with the United (...) Kingdom’s commitments under the United Nations Convention on the Rights of Persons with Disabilities. Stressing the need for the law to keep in step with advances in science, the article concludes with robust recommendations for improvements, based on the latest research in neuroscience, to the way in which life-sustaining treatment decisions are made. This would mean that the wishes of patients, including those with covert awareness, can be better reflected in best interests assessments. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 77-90.

There has long been interest in identifying and studying ‘‘successful psychopaths.” This study sampled psychologists with an interest in law, attorneys, and clinical psychology professors to obtain descriptions of individuals considered to be psychopaths who were also successful in their endeavors. The results showed a consistent description across professions and convergence with descriptions of traditional psychopathy, though the successful psychopathy profile had higher scores on conscientiousness, as measured within the five-factor model (FFM). These results are useful in documenting the existence (...) of successful psychopathy, demonstrating the potential benefit of informant methodology, and providing an FFM description that distinguishes successful psychopaths from unsuccessful psychopaths studied more routinely within prison settings. (shrink)

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws’ impacts and the development of future public health laws. We conducted key-informant interviews in 35 states (...) with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws’ provisions and to identify successful legal approaches to protecting young athletes. (shrink)

A widely accepted framework governs biomedical research and the practice of medicine in the civilian sector, but no such framework exists to guide the military in how it should treat its own personnel. Civilian bioethical principles are unsuitable because of fundamental differences between civilian and military core values. This paper proposes a framework for military bioethics. It begins by describing core military values, articulating how they differ from civilian goals and values, and explaining how these differences limit the ability of (...) civilian bioethical principles to govern military biomedicine. The paper then puts forward a set of more appropriate principles for the military and discusses how these principles apply in three main areas of controversy within military bioethics: the use of military personnel as research subjects; the deployment use of biomedical agents; and the obligations of military physicians toward their own troops. (shrink)

Le projet à l’origine de ce dossier thématique est celui d’une étude comparative de l’expérimentation telle qu’elle apparaît dans les sciences de la nature et dans les sciences humaines et sociales. Il illustre et prolonge les réflexions d’un séminaire de recherche sur le même sujet, organisé par Catherine Allamel-Raffin, qui s’est tenu pendant deux ans (2017-2018) à l’université de Strasbourg grâce à un financement de la Misha (Maison Interuniversitaire des Sciences de l’Homme – Alsace). Les...

Experimental psychologists in the learning tradition stress the importance of three of the authors' four key variables of experimental design. We review research investigating the roles played by these variables in studies of choice from our laboratory. Supporting the authors' claims, these studies show that the effects of these variables are not fixed and should not be taken for granted.

Grandparental altruism may be partially understood in the same way as other instances of altruism. Acts of altruism often occur in a context in which the actor has a broader sense of cause and effect than is evident in more typical behavioral interactions where cause and effect appear relatively transparent. Many believe that good deeds will ultimately produce good results.

Future economic game research should include: (1) within-culture comparisons between individuals exposed and not exposed to market integration; (2) use of a game (such as the “Sharing Game”) that enables subjects to maximize their earnings while also maximizing those of the other participant; and (3) assessment of performance in a repeated-trials format that might encourage sensitivity to the games' economic contingencies.

Name der Zeitschrift: Semiotica Jahrgang: 2017 Heft: 215 Seiten: 73-90.

Schistosoma mansoni is one of several species of trematode helminths responsible for schistosomiasis, a major parasitic infection of man. Genetic analysis in mice has revealed that the protective immunity induced against this parasite by an attenuated larval vaccine is strongly influenced by genes regulating the activation of macrophage effector cells. The latter finding suggests that the induction of cell‐mediated immunity may be a successful strategy for a non‐living vaccine against the human infection.

In 1997 the Royal Pharmaceutical Society of Great Britain published a report entitledFrom Compliance to Concordance: Achieving Shared Goals in Medicine Taking. This article applies this new model—of doctors and patients working together towards a shared goal—to the prescribing of hormonal forms of contraception. It begins by critically evaluating the current dominant model of contraceptive prescribing. It claims that this model tends to stereotype all women, but particularly young, poor and black women, as unreliable and ill-informed contraceptors who need to (...) be advised and even controlled by much more knowledgeable and socially responsible family planning experts. The article then suggests how a much more egalitarian model of contraceptive prescribing might be put into practice, whilst acknowledging the existence of many serious obstacles to such a radical shift within family planning services. In conclusion, the article suggests that until contraceptive prescribers begin to take women’s experiences of, and concerns about, hormonal contraceptives seriously they will fail to develop a potentially much more effective and liberating model of family planning. (shrink)

Couples therapy has long been regarded as one of the most demanding forms of psychotherapy because of the way it challenges therapists to combine the insights of dynamic psychology with the power and clarity of systems dynamics. In this exciting new volume, Gordon Wheeler and Stephanie Backman, couples therapists with broad training and long years of experience, present dramatic new approaches that at last integrate the dynamic/self-organizational and the systemic/behavioral schools of thought. Building on the insights of Gestalt psychology (...) and psychotherapy, the authors show us how a truly phenomenological approach, based on the clients' own experience and goals, holds the key to a dramatic increase in therapeutic power and flexibility. The fifteen engaging chapters demonstrate the application of this approach to issues of intimacy, self-construction, power and abuse, "resistance," growth, and shame - and to such diverse and challenging populations as abuse survivors and their partners, remarried couples, gay and lesbian couples, and couples with "personality" or "character" disorders. In the process, the authors offer a fresh perspective that will serve to re-energize the couples therapist's work in this challenging area. _On Intimate Ground_ contributes new insights to many of the most timely and provocative questions in the field today. (shrink)

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

Public protest continued to represent a prominent form of social activism in democratic societies during the COVID-19 pandemic. In Australia, a lack of specific legislation articulating protest rights has meant that, in the context of pandemic restrictions, such events have been treated as illegal mass gatherings. Numerous large protests in major cities have, indeed, stirred significant public debate regarding rights of assembly during COVID-19 outbreaks. The ethics of infringing on protest rights continues to be controversial, with opinion divided as to (...) whether public health goals or human rights should take precedence. This paper applies public health ethical theory to an in-depth analysis of arguments on both sides of the debate. Using the Nuffield Council on Bioethics framework as a backdrop, proportionality and necessity of restrictions are understood as key concepts that are common to both public health and human rights perspectives. The analysis presented here finds a middle-ground between the prevailing arguments on opposing sides and is further able to rationalize the use of protest itself as an important element of a mature public health ethics response to restrictive policy. Thus, this paper aims to influence public health policy and legislation regarding protest rights during public health emergencies. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 283-298, Spring 2022.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

In this article, I consider the harms inflicted upon transgender persons through “misgendering,” that is, such deployments of gender terms that diminish transgender persons’ selfrespect, limit the discursive resources at their disposal to define their own gender, and cause them microaggressive psychological harms. Such deployments are morally contestable, that is, they can be challenged on ethical or political grounds. Two characterizations of “woman” proposed in the feminist literature are critiqued from this perspective. When we consider what would happen to transgender (...) women upon the broad implementation of these characterizations within transgender women’s social context, we discover that they suffer from two defects: they either exclude at least some transgender women, or else they implicitly foster hierarchies among women, marginalizing transgender women in particular. In conclusion, I claim that the moral contestability of gender-term deployments acts as a stimulus to regularly consider the provisionality and revisability of our deployments of the term “woman.”. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

Research that is integrated into ongoing clinical activities holds the potential to accelerate the generation of knowledge to improve the health of individuals and populations. Yet integrating research into clinical care presents difficult ethical and regulatory challenges, including how or whether to obtain informed consent. Multiple empirical studies have explored patients' and the public's attitudes toward approaches to consent for pragmatic research. Questions remain, however, about how to use the resulting empirical data in resolving normative and policy debates and what (...) kind of data warrants the most consideration. We recommend prioritizing data about what people consider acceptable with respect to consent for pragmatic research and data about people's informed, rather than initial, preferences on this subject. In addition, we advise caution regarding the weight given to majority viewpoints and identify circumstances when empirical data can be overridden. We argue that empirical data bolster normative arguments that alterations of consent should be the default in pragmatic research; waivers are appropriate only when the pragmatic research would otherwise be impracticable and has sufficiently high social value. (shrink)

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

A memoir of one womanÆs struggle against breast cancer reveals how she channeled her energy to transform her life, even as she was dying.

While popular cultural representations portray the “new father” of the past two decades as more involved, more nurturing, and capable of coparenting, many argue that actual fathering conduct has not kept pace. Others, however, question the extent to which the culture of fatherhood does indeed support involved fathering and, if so, what this involvement entails. This study aims to contribute to the exploration of the culture of fatherhood through an analysis of a yearlong Canadian newspaper series dedicated to family issues. (...) Findings suggest that through representations of parental guilt, parental responsibility, work—family balance issues, and hegemonic masculinity, mothers continue to be positioned as primary parents. Support for father involvement, to the extent that it exists, occurs within the framework of fathers as part-time, secondary parents whose relationship with children remains less important than mothers'. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Far from an elite practice reserved for the highly educated, criticism is all around us. We turn to the Yelp reviewers to decide what restaurants are best, to Rotten Tomatoes to guide our movie choices, and to a host of voices on social media for critiques of political candidates, beach resorts, and everything in between. Yet even amid this ever-expanding sea of opinions, professional critics still hold considerable power in guiding how we make aesthetic judgements. Philosophers and lovers of art (...) continue to grapple with questions that have fascinated them for centuries: How should we engage with works of art? What might enhance such encounters? Should some people’s views be privileged? Who should count as a critic? And do critics actually help us appreciate art? In Two Thumbs Up, philosopher Stephanie Ross tackles these questions, revealing the ways that critics influence our decisions, and why that’s a good thing. Starting from David Hume’s conception of ideal critics, Ross refines his position and makes the case that review-based journalistic or consumer reporting criticism proves the best model for helping us find and appreciate quality. She addresses and critiques several other positions and, in the process, she demonstrates how aesthetic and philosophical concerns permeate our lives, choices, and culture. Ultimately, whether we’re searching for the right wine or the best concert, Ross encourages us all to find and follow critics whose taste we share. (shrink)

Owned objects are typically viewed as non-fungible-they cannot be freely interchanged. We report three experiments (total N=312) demonstrating this intuition in preschool-aged children. In Experiment 1, children considered an agent who takes one of two identical objects and leaves the other for a peer. Children viewed this as acceptable when the agent took his own item, but not when he took his peer's item. In Experiment 2, children considered scenarios where one agent took property from another. Children said the victim (...) could take back her own property from the perpetrator, but that she could not take an identical object belonging to the perpetrator. Finally, in Experiment 3A and 3B, children considered scenarios where a teacher could give a child either of two objects to play with-an object that the child had recently played with, or another object that looked the same. Children were more likely to say that the teacher should give the object recently played with when it belonged to the child, compared with when it belonged to the teacher. These findings are informative about the basis of judgments that property is non-fungible, and about young children's representation of ownership rights. They show that children's representation of ownership rights is not limited to principles protecting owners from being deprived. Our findings instead suggest that ownership rights are viewed as pertaining to individual objects. (shrink)

ArgumentIn this article, we trace shifting narratives of trauma within psychiatric, neuroscience, and environmental epigenetics research. We argue that two contemporary narratives of trauma – each of which concerns questions of time and psychopathology, of the past invading the present – had to be stabilized in order for environmental epigenetics models of suicide risk to be posited. Through an examination of these narratives, we consider how early trauma came to be understood as playing an etiologically significant role in the development (...) of suicide risk. Suicide, in these models, has come to be seen as a behavior that has no significant precipitating event, but rather an exceptional precipitating neurochemical state, whose origins are identified in experiences of early traumatic events. We suggest that this is a part of a broader move within contemporary neurosciences and biopsychiatry to seelife as post: seeing life as specific form of post-traumatic subjectivity. (shrink)

When a liberal-democratic state signs a treaty or wages a war, does its whole polity do those things? In this article, we approach this question via the recent social ontological literature on collective agency. We provide arguments that it does and that it does not. The arguments are presented via three considerations: the polity's control over what the state does; the polity's unity; and the influence of individual polity members. We suggest that the answer to our question differs for different (...) liberal-democratic states and depends on two underlying considerations: the amount of discretion held by the state's officeholders; the extent to which the democratic procedure is deliberative rather than aggregative. (shrink)

Pragmatic clinical trials offer important benefits, such as generating evidence that is suited to inform real-world health care decisions and increasing research efficiency. However, PCTs also present ethical challenges. One such challenge involves the management of information that emerges in a PCT that is unrelated to the primary research question, yet may have implications for the individual patients, clinicians, or health care systems from whom or within which research data were collected. We term these findings as?pragmatic clinical trial collateral findings,? (...) or?PCT-CFs?. In this article, we explore the ethical considerations associated with the identification, assessment, and management of PCT-CFs, and how these considerations may vary based upon the attributes of a specific PCT. Our purpose is to map the terrain of PCT-CFs to serve as a foundation for future scholarship as well as policy-making and to facilitate careful deliberation about actual cases as they occur in practice. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)